Gao Liansheng, Peng Yucong, Xu Weilin, He Pingyou, Li Tao, Lu Xiaoyang, Chen Gao
Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
Stem Cells Int. 2020 Nov 5;2020:2853650. doi: 10.1155/2020/2853650. eCollection 2020.
Spinal cord injury (SCI) is one of the serious neurological diseases that occur in young people with high morbidity and disability. However, there is still a lack of effective treatments for it. Stem cell (SC) treatment of SCI has gradually become a new research hotspot over the past decades. This article is aimed at reviewing the research progress of SC therapy for SCI.
Review the literature and summarize the effects, strategies, related mechanisms, safety, and clinical application of different SC types and new approaches in combination with SC in SCI treatment.
A large number of studies have focused on SC therapy for SCI, most of which showed good effects. The common SC types for SCI treatment include mesenchymal stem cells (MSCs), hematopoietic stem cells (HSCs), neural stem cells (NSCs), induced pluripotent stem cells (iPSCs), and embryonic stem cells (ESCs). The modes of treatment include in vivo and in vitro induction. The pathways of transplantation consist of intravenous, transarterial, nasal, intraperitoneal, intrathecal, and intramedullary injections. Most of the SC treatments for SCI use a number of cells ranging from tens of thousands to millions. Early or late SC administration, application of immunosuppressant or not are still controversies. Potential mechanisms of SC therapy include tissue repair and replacement, neurotrophy, and regeneration and promotion of angiogenesis, antiapoptosis, and anti-inflammatory. Common safety issues include thrombosis and embolism, tumorigenicity and instability, infection, high fever, and even death. Recently, some new approaches, such as the pharmacological activation of endogenous SCs, biomaterials, 3D print, and optogenetics, have been also developed, which greatly improved the application of SC therapy for SCI.
Most studies support the effects of SC therapy on SCI, while a few studies do not. The cell types, mechanisms, and strategies of SC therapy for SCI are very different among studies. In addition, the safety cannot be ignored, and more clinical trials are required. The application of new technology will promote SC therapy of SCI.
脊髓损伤（SCI）是发生于年轻人的严重神经疾病之一，发病率和致残率高。然而，目前仍缺乏有效的治疗方法。在过去几十年中，干细胞（SC）治疗SCI逐渐成为一个新的研究热点。本文旨在综述SC治疗SCI的研究进展。
查阅文献，总结不同类型SC及与SC联合的新方法在SCI治疗中的作用、策略、相关机制、安全性及临床应用。
大量研究聚焦于SC治疗SCI，多数显示出良好效果。用于SCI治疗的常见SC类型包括间充质干细胞（MSC）、造血干细胞（HSC）、神经干细胞（NSC）、诱导多能干细胞（iPSC）和胚胎干细胞（ESC）。治疗方式包括体内和体外诱导。移植途径包括静脉注射、动脉注射、鼻内注射、腹腔注射、鞘内注射和髓内注射。多数SC治疗SCI使用的细胞数量从数万到数百万不等。SC给药的早晚、是否应用免疫抑制剂仍存在争议。SC治疗的潜在机制包括组织修复与替代、神经营养、促进血管生成、再生、抗凋亡和抗炎。常见的安全问题包括血栓形成和栓塞、致瘤性和不稳定性、感染、高热甚至死亡。最近，一些新方法，如内源性SCs的药理学激活、生物材料、3D打印和光遗传学也已被开发出来，这极大地改善了SC治疗SCI的应用。
多数研究支持SC治疗对SCI的效果，少数研究则不然。不同研究中SC治疗SCI的细胞类型、机制和策略差异很大。此外，安全性不容忽视，需要更多的临床试验。新技术的应用将推动SC治疗SCI的发展。
